CriticalReview_01(1) - Copy - Copy

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Oct 30, 2023

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Critical Review # 1 In your own words briefly summarize the main points from the textbook, article and video Currently, the Medicare program offers health insurance coverage to over 49 million Americans and is responsible for hundreds of billions of dollars in federal spending. Medicare is comprised of many components that provide financial assistance for a range of services. Part A of the insurance policy provides coverage for inpatient hospital treatment, skilled nursing facility care, home health care, and hospice care. Part B of the insurance policy offers compensation for outpatient medical expenses. It includes coverage for prescription pharmaceuticals, medical equipment, preventive care, laboratory tests, and specialized doctor services. Medicare Advantage, also known as Part C, is provided by private organizations that have been authorized by Medicare. It encompasses all the benefits of Part A and Part B plans. Part D, often known as prescription drug coverage, assists in mitigating the expenses associated with prescription drugs, including vaccines or shots. Since its inception in 1965, the fundamental design or framework of Medicare has remained unaltered, apart from the inclusion of prescription medication coverage in 2006. The complexity of the Medicare system increases significantly when considering the cost-sharing obligations of beneficiaries . By 2030, the youngest individuals from the baby boomer generation will have reached the age at which they can join in Medicare. The youngest individuals belonging to the baby boomer generation will reach the age of 65 or older. It is projected that the population of individuals aged 65 and over will increase from 40 million to 67 million. It is expected that the

number of persons enrolled in Medicare will increase from 46 million to over 78 million between 2010 and 2030 ( Brookings Institution; 2015) . The future health condition of prospective Medicare recipients remains uncertain. In comparison to earlier generations, the baby-boom generation experiences extended life expectancies and significantly reduced smoking rates. However, they also exhibit increased rates of obesity and diabetes. Specifically, there will be a notable increase in the Hispanic population, who traditionally have larger families and will become eligible for Medicare ( Butler, 201 8). Additionally, there will be a rise in the population of obese and morbidly obese individuals, projected to increase from 28% in 2010 to 47% in 2030. Furthermore, there will be an increase in the number of individuals with multiple chronic diseases, a decrease in the number of smokers, and an overall rise in life expectancy due to technological advancements. However, this increase in life expectancy may also lead to a greater number of years spent in poor health or with disabilities. It has been predicted that Medicare expenditure will increase from $131,000 in 2010 to $223,000 by 2030. The aging of the U.S. population, along with other causes, will have a substantial impact on the country's economy. This presents a challenge to the sustainability of the social security and Medicare programs. Restructuring Medicare, a health policy brief written by Amanda Cassidy and titled "Restructuring Medicare," focuses on the potential consequences on beneficiaries of the several suggestions that have been proposed for restructuring Medicare cost-sharing by policymakers. Specifically, the focus is on how these reforms would affect the beneficiaries' ability to pay for their healthcare. The current structure of Medicare is often seen as being antiquated, unpredictable, and devoid of beneficiary protections such as a cap on out-of-pocket costs. In addition, it does little to motivate patients to seek the best available care or to avoid therapy that is not necessary. Others see these reforms as a strategy to decrease government spending,

primarily by shifting costs to beneficiaries, while some supporters of Medicare redesign want to modify the way benefits are organized . Are there any common points that were raised in the textbook, article, and the video? If yes, briefly describe them . The video, article and textbook discuss several prevalent arguments. The sources describe numerous challenges that Medicare currently confronts and may encounter in the future. It explores methods to enhance Medicare, reorganize Medicare, and advocate for Medicare reform. Policymakers are not dealing with an inefficient program that allows excessive spending, but rather the difficulty of providing care for a Medicare beneficiary population that is growing rapidly." (Cassidy , 201 3 ) . A notable resemblance observed in both the film and paper was the integration of Medicare components A, B, and D. The article cited this as a potential reform measure, along with the implementation of a solitary deductible, appropriate copayments, a limit on maximum expenses borne by the individual, and incentives to encourage the utilization of high-quality healthcare services ("Health Policy Brief: Restructuring Medicare," 2013). The movie highlighted the significant achievement of integrating Part A, B, and D. Currently, as Part D operates independently, there are no incentives for patients to opt for more expensive prescriptions, which might potentially lead to reduced spending in Part A and B. For instance, certain treatments that have the potential to avoid emergency department visits may be comparatively pricier under Part D. However, their use could substantially decrease expenses associated with Parts A and B (Brookings Institution, 2015 .( What are the main challenges and strengths of the US government health insurance programs ? The United States grapples with the formidable issue of exorbitant healthcare expenses,

which have far-reaching implications for individual conduct and the economy. It is unsurprising that individuals in the United States allocate a significant amount of money on healthcare expenditures annually. The nation incurs costs associated with wellness and health, such as co- pays, high deductibles, expensive insurance premiums, and other out-of-pocket expenses. In the United States, healthcare expenses have experienced a significant surge over the past few decades. Obtaining optimal healthcare is hindered by various difficulties. Globally, the maintenance of healthcare quality and cost is a persistent concern. A significant portion of the American population lacks access to healthcare due to the financial constraints faced by millions of low-income households, preventing them from affording the same level of care as those in higher income brackets (Brookings Institution; 2015). Americans who belong to low-income families cannot afford healthcare due to new costly drugs and technologies. In the twenty-first century, medicine is increasingly dependent on technology. The medical technology cost is not decreasing but increasing hence contributing to the costs of medical care, which is spiraling. Several professionals in healthcare is making a lot of progress in healthcare using sophisticated technology, which is always expensive, and the families at the lower level cannot access medical care. For instance, pediatric heart care uses intensive technology, making it very expensive, and most Americans with low incomes get a lot of difficulties reaching it. Since the current healthcare is run by digital technologies, with several medical equipment running on digital networks, clinics, hospitals, and other health care institutions mainly depend on information software in their hospitals. They are making it very hard for ordinary citizens to afford healthcare. Physician fees is another problem that causes high cost in healthcare. Their fees account for nearly twenty percent of the overall costs in healthcare. In the United States , physicians are compensated highly than other personnel in the country. Compared to the other

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